1982699906 NPI number — JOHN WILLIAM BATICH M.D.

Table of content: CAITLIN ELAINE CELEBRE M.A., CCC-SLP (NPI 1609691138)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982699906 NPI number — JOHN WILLIAM BATICH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BATICH
Provider First Name:
JOHN
Provider Middle Name:
WILLIAM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982699906
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 LEROY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POTSDAM
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13676-1799
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-265-3300
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
80 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13617-1450
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-714-3170
Provider Business Practice Location Address Fax Number:
315-714-3176
Provider Enumeration Date:
09/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  175660 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 174400000X , with the licence number: 21794 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 146416 . This is a "UNITED MINE WORKERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 845896 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21794 . This is a "UPPER OHIO VALLEY HEALTH" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 264495 . This is a "CARELINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 175660 . This is a "NYS LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2540558 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3810001404 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7626136 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7200274 . This is a "CIGNA" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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